Salvage haploidentical transplantation for graft failure using reduced-intensity conditioning.

Abstract:

:Graft failure is a major concern after cord blood transplantation (CBT) or HLA-haploidentical transplantation (haplo-SCT). As patients who undergo CBT or haplo-SCT almost always lack both matched-related and -unrelated donors, salvage transplantation would also be limited to either CBT or haplo-SCT. In this study, we assessed eight patients who received haplo-SCT as salvage therapy for graft failure. Five and three patients had received haplo-SCT and CBT, respectively, which resulted in graft failure. The median interval from the failed transplantation to salvage transplantation in six patients with primary graft failure was 33.5 days. The reduced-intensity conditioning regimen consisted of fludarabine, thiotepa, rabbit antithymocyte globulin and low-dose TBI. All eight patients achieved neutrophil engraftment, and seven patients achieved platelet recovery. The median times to neutrophil recovery and platelet recovery were 10 and 20 days, respectively. Three patients died from treatment-related causes: two from GVHD and one from rupture of carotid artery aneurysm. Five patients are alive, at a median follow-up of 946 days. The probability of overall survival at 5 years was 75%. These findings may serve as a rationale for giving precedence to haplo-SCT over CBT in salvage SCT after graft failure.

journal_name

Bone Marrow Transplant

authors

Yoshihara S,Ikegame K,Taniguchi K,Kaida K,Kim EH,Nakata J,Kato R,Inoue T,Fujioka T,Tamaki H,Okada M,Soma T,Ogawa H

doi

10.1038/bmt.2011.84

subject

Has Abstract

pub_date

2012-03-01 00:00:00

pages

369-73

issue

3

eissn

0268-3369

issn

1476-5365

pii

bmt201184

journal_volume

47

pub_type

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